Healthcare Provider Details

I. General information

NPI: 1073129896
Provider Name (Legal Business Name): LOTUS NEST COUNSELING SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/17/2020
Last Update Date: 11/26/2024
Certification Date: 11/26/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

110 WINDSOR AVE
AMERICUS GA
31709-3531
US

IV. Provider business mailing address

110 WINDSOR AVE
AMERICUS GA
31709-3531
US

V. Phone/Fax

Practice location:
  • Phone: 229-596-1199
  • Fax: 229-596-1200
Mailing address:
  • Phone: 229-596-1199
  • Fax: 229-596-1200

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number State

VIII. Authorized Official

Name: BRIANNA RAE BROWN
Title or Position: CHIEF EXECUTIVE OFFICER
Credential: LMFT
Phone: 229-596-1199